Human papillomavirus and risk factors for cervical cancer in Chennai, India:: A case-control study

被引:127
作者
Franceschi, S
Rajkumar, T
Vaccarella, S
Gajalakshmi, V
Sharmila, A
Snijders, PJF
Muñoz, N
Meijer, CJLM
Herrero, R
机构
[1] Int Agcy Res Canc, Unit Field & Intervent Studies, F-69372 Lyon 08, France
[2] Inst Canc Res, Madras, Tamil Nadu, India
[3] Epidemiol Res Ctr, Madras, Tamil Nadu, India
[4] Free Univ Amsterdam, Med Ctr, Amsterdam, Netherlands
[5] Costa Rican Fdn Hlth Sci, Proyecto Epidemiol Guanacaste, San Jose, Costa Rica
关键词
cervical neoplasms; human papillomavirus; sexual habits; reproduction; hygiene;
D O I
10.1002/ijc.11350
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
To evaluate the role of human papillomavirus (HPV) and other risk factors in the aetiology of invasive cervical carcinoma (ICC), we conducted a hospital-based case-control study in Chennai, Southern India. A total of 205 ICC cases (including 12 adenocarcinomas) and 213 frequency age-matched control women were included. HPV DNA in cervical cells was evaluated by means of a polymerase chain-reaction assay. Odds ratios (ORs) and corresponding 95% confidence intervals (Cls) were computed by means of unconditional multiple logistic regression models. HPV infection was detected in all but one ICC cases and in 27.7% of control women (OR = 498). Twenty-three different HPV types were found. HPV 16 was the most common type in either cases or controls, followed by HPV 18 and 33. The association of ICC with HPV 18 and HPV 16-associated types was somewhat stronger than the one with HPV 16. Multiple HPV infections did not show a higher OR for ICC than single infections. Other than HPV infection, high parity (OR for >4 vs. less than or equal to2 births = 7.3), a woman's report of her husband's extramarital sexual relationships (OR = 10.0) and early menopause (OR for <45 vs. >= 45 years = 4.2) were significantly associated with ICC, also after restricting the analysis to HPV-positive cases and controls. Poor hygienic conditions were associated with an increased risk of HPV infection among control women but not with ICC risk among HPV-positive women. A vaccine against HPV 16 and 18 may be effective in more than three-quarters of ICC in the study area. (C) 2003 Wiley-Liss, Inc.
引用
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页码:127 / 133
页数:7
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